经皮椎体成形术在椎体肿瘤治疗中的临床应用.pdfVIP

放射学实践2008年1月第23卷第1期 Radiol Practice，Jan 2008，Vol 23，No．1 69 介入放射学 经皮椎体成形术在椎体肿瘤治疗中的临床应用 张栋，倪才方，陈珑，刘一之，杨惠林，唐天驷 【摘要】 目的：探讨经皮椎体成形术(PVP)治疗椎体肿瘤性病变的临床效果。方法：应用PVP治疗32例 44个椎体 良恶性肿瘤病变。在C型臂 X光机透视导向下经皮穿刺到病变椎体后注入骨水泥。记录患者术前、术后24 h、术后1周、 术后 1个月的疼痛视觉模拟划线得分(VAS)，观察止痛效果和并发症。结果：44个椎体皆一次穿刺成功，穿刺成功率 100％。一月后疼痛缓解程度为：完全缓解(CR)者8例，部分缓解(PR)者21例，轻度缓解(MR)者2例，无效(NR)者 1 例，总有效率(CR+PR)为90．6 (29／32)。患者术前与术后24 h、术后1周、术后 1个月的VAS得分差异有显著性意义 (PO．05)。PVP术后8个椎体发生无症状的骨水泥渗漏无1例椎体塌陷加重或发生新的骨折，无1例发生严重并发症。 结论：PVP治疗椎体肿瘤性病变成功率高，效果良好。 【关键词】 脊椎肿瘤；体层摄影术，X线计算机；放射学，介入性 【中图分类号】R738．1；R815．2 【文献标识码】A 【文章编号】1000—0313(2008)01-0069—04 Clinical Application of Percutaneous Vertebroplasty in the Treatment of Vertebral Tumour ZHANG Dong，NI Cai—fang， CHEN Long，et a1．Department of Interventional Radiology，the First Affiliated Hospital of Suzhou University，Jiangsu 215006，P．R．China [Abstract] Objective：To investigate the clinical efficacy of percutaneous vertebroplasty(PVP)in the treatment of vertebral tumour．Methods：Of 32 cases with 44 vertebral tumors including metastatic tumor(26 patients，36 vertebral bodies involved)，myeloma(2 patients，4 vertebral bodies)，hemangioma(4 patients，4 vertebral bodies)，percutaneous puncture of vertebral lesions were performed under C-arm fluoroscopy and bone cement was injected．The visual analogue seale point (VAS)(10 point scale)were recorded before and 24 hours，one week and one month after vertebropJgsty respectively．Re— sult of pain relief and complications were observed．Results：100 success rate of PVP was obtaified．Complete relief(CR) was assessed in 21 patients，partial relief(PR)in 21 patients，mild relief(MR)in 2 patients and no pain relief in 1 patient 30 days after operation．The total rate of pain relief(CR+PR)was 90．6 (29／32 patients)．There are significant differ— ences a